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Developing a system map

In this step, we explore some of the considerations around developing a healthcare system map.

Developing an effective map of a healthcare system should involve (but is not limited to) the following practical steps:

  • Identify a goal (an initial aim)
  • Gather people (representing diverse perspectives and groups)
  • Gather materials (paper/flipcharts, markers/pens, post-its, computer/software)
  • Brainstorm (ideas, perspectives, be inclusive)
  • Make decisions (what to include and exclude)
  • Connect factors and check/collect extra information
  • Write/draw (at every stage)
  • Be flexible

The basic line of thought when mapping out a system should include interconnections, relationships, causal relationships and scale (in terms of the individual, group community, national, and global occurrence or effect).

Let’s take a look at some visual examples, below:

The six building blocks are presented under health system functions. This relates to health performance systems, which includes criteria including access, coverage, efficiency, equity, quality, safety and sustainability. These criteria relate to impact, which includes responsiveness, risk protection and improved health

Adapted from USAID (2012) – click on image to expand size.

Improved health outcomes are central in this image. The six building blocks surround the inner circle, with the outer circles including the range of healthcare organisations relating to each block.

Adapted from USAID (2012) – click on image to expand size.

From these two diagrams, we can see the range of interactions and actors in the healthcare system as organised by the six building blocks identified by the World Health Organization (WHO).

Diagram explained in the text below.

Adapted from Van Olmen et al .(2012: 4) – click on image to expand size.

The ‘Health System Dynamics Framework’ devised by Van Olmen et al. (2012: 3-4) presents the organisation and delivery of healthcare services as the core element of a healthcare system, which interlinks with the other elements identified in the diagram.

Your task

Are there any other practical steps or tips you could think of that would help in mapping out a healthcare system? Share your suggestions in the comments area.


References

USAID (2012) The Health System Assessment Approach: A How-To Manual [online] available from https://www.hfgproject.org/wp-content/uploads/2015/02/HSAA_Manual_Version_2_Sept_20121.pdf [22 April 2020]

Van Olmen, J., Criel, B., Bhojani, U., Marchal, B., Van Belle, S., Chenge, F., and Kegels, G. (2012) ‘The Health System Dynamics Framework: The Introduction of An Analytical Model for Health System Analysis and its Application to Two Case-studies’. Health Culture and Society 2 (1), 1-21

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This article is from the free online course:

Understanding Systems Thinking in Healthcare

Coventry University